Provider Demographics
NPI:1710270202
Name:TAMAS, ANDREA (LVN)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:TAMAS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 N KINGS RD
Mailing Address - Street 2:#304
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90069-4350
Mailing Address - Country:US
Mailing Address - Phone:323-650-6024
Mailing Address - Fax:
Practice Address - Street 1:927 N KINGS RD
Practice Address - Street 2:#304
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90069-4350
Practice Address - Country:US
Practice Address - Phone:323-650-6024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-17
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN 185230164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse